Carpal Tunnel, Trigger Finger, and Spinal Stenosis: The Rest of the Story

Abstract

Amyloidosis is a deadly systemic disease in which misfolded proteins accumulate in human tissue eventually leading to morbid dysfunction in multiple organ systems. The prognosis of untreated amyloidosis is poor. Orthopedic manifestations of amyloidosis include carpal tunnel syndrome (CTS), trigger digit, distal biceps tendon rupture, rotator cuff disease, and lumbar spinal stenosis. These orthopedic conditions are early red flags for systemic amyloidosis. CTS is often the earliest manifestation and can precede the disease by over four years. With the advent of medications that can slow the progression of amyloidosis, particularly in the early stages of the disease, it is imperative to diagnose amyloidosis early on. Both primary care physicians and orthopedic surgeons can recognize the various orthopedic conditions associated with amyloidosis and play a vital role in early disease detection. Awareness of the musculoskeletal presentation of systemic amyloidosis can lead to earlier detection and treatment that can delay the progression of the disease.